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Primary vaginal sarcoma treated with upfront fertility-sparing surgery
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  1. Jose Martin Saadi1,
  2. Myriam Perrotta1,
  3. Lucrecia Bolaño1,
  4. Diego Odetto1,
  5. Juan Pablo Segundo Cortez1 and
  6. Florencia Noll1,2
  1. 1 Department of Gynecologic Oncology, Hospital Italiano de Buenos Aires, CABA, Ciudad Autonoma, Argentina
  2. 2 Department of Gynecologic Oncology, Sanatorio Allende Cerro, Cordoba, Argentina
  1. Correspondence to Dr Florencia Noll, Gynecologic oncology, Hospital Italiano de Buenos Aires, Buenos Aires C1199, Argentina; florencia.noll{at}hospitalitaliano.org.ar

https://doi.org/10.1136/ijgc-2020-001569

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    A 31-year-old nulliparous woman was referred for a 5 cm vaginal tumor diagnosed by physical examnation. She complained of post-coital bleeding in the prior 2 months. Pelvic examination showed a suspicious 5 cm exophytic mass, located on the middle-upper third of the vagina. No lesions were visible in the lower third of the vagina or in the cervix. The tumor biopsy confirmed a vaginal leiomyosarcoma FIGO stage I. An abdominopelvic MRI scan showed a 5 cm heterogeneous vaginal tumor, without cervical extension. The absence of distant disease was confirmed with a positron emission tomography/CT scan.

    After a multidisciplinary discussion, a laparotomic sub-total colpectomy was recommended. Surgical time was 200 min, the estimated blood loss was 300 mL. The patient had an uneventful post-operative period. Hospital stay was 4 days. The pathology results showed a 4 cm vaginal leiomyosarcoma (mitotic activity index: 10 mitosis/10 high power field) no lymphovascular space invasion, and the presence of necrosis. Immunohistochemistry showed positivity for smooth muscle actin and desmin, and negativity for myogenin. The surgical resection margins were negative. The multidisciplinary committee decided no adjuvant treatment. Currently, she is having regular menses and intercourse. After a follow-up time of 37 months, she has no evidence of disease.

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    Footnotes

    • Contributors All authors actively participated in the study providing input including, substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; drafting of the article, or provision of critical revision for important intellectual content; and final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.